A vision for community pharmacy – The Nuffield Trust


The King’s Fund and the Nuffield Trust were commissioned by Community Pharmacy England to develop a vision for community pharmacy that will underpin a strategy for the sector and support Community Pharmacy England in its leadership role, its work with members and in negotiations. Our independent report describes that vision and the actions which will be required to turn the vision into reality. 

It sets out the scale of ambition for community pharmacy, in particular showing how community pharmacy can contribute to key policy goals around population health, prevention and increasing levels of demand in primary care. It also explores the barriers which have held progress back in the past and will need to be addressed to achieve the vision, and the enablers which give us confidence that progress can be made now. 

This vision document is being published at a time of unprecedented challenge for the health and care system in England. The health and care needs of the population are changing. People are living longer with multiple, complex, long-term conditions and increasingly require long‑term support from many different services and professionals. Community pharmacy, like all parts of the health and care system, needs to adapt to meet those needs. 

Over the course of the next decade, community pharmacy will undergo significant transformation, becoming central to the delivery of joined-up, responsive and person-centred community-based health and care services, with increased investment from commissioners reflecting the increased significance of community pharmacy in the health care ecosystem. 

Patients and the public will be able to access medicines, further clinical services and preventive services which are accessible and clearly understandable, and that give them choice where appropriate, continuity where required, and confidence in the advice and treatments they receive. Community pharmacies will play a particularly important role in supporting self-care and helping their local populations to stay healthy and well. The growth of the independent prescriber role will mean that a large proportion of patients with self-limiting conditions will use community pharmacy as their first contact point for treatment and advice. And the services offered by community pharmacy will be integrated with other parts of the health and care system, particularly other parts of primary care, with information and pathways flowing seamlessly across different providers and settings. This will ensure that patients that need to be directed to other appropriate services can be quickly directed to the right part of the system. 

Community pharmacy will make a significant and valued contribution to the goals of the wider health and care system, including the ambitions of their local integrated care board (ICB). It will have a key role to play in addressing inequalities, both in health status and in access to health care. 

Pharmacies will be thriving businesses, continuing with their core role as a key part of the medicines supply chain in purchasing and dispensing drugs, while broadening the range of contracted and funded activities they undertake. They will be able to offer attractive careers with opportunities for training and development for pharmacists, pharmacy technicians and other support roles. Pharmacists will be valued members of multidisciplinary primary care teams, working with others to improve the health of their local populations. 

From our starting point in 2023, we can see that there is clearly significant variation within the sector in terms of capacity and capability. In developing this vision, we have sought to design an approach which is deliverable by most community pharmacies, as we believe that this will mean that implementation is likely to be more successful. A national offer that is offered by all will be understandable to the public and may also avoid the frustration of people and patients being turned away from services. However, our framework also allows for those pharmacies with greater capacity to move further, faster. 

There are four dimensions to the role of the future community pharmacy, all underpinned by a continuous improvement approach.

Preventing ill health and supporting wellbeing 

Community pharmacies will play a key role in supporting people and communities to stay healthy and well, with a particular focus on reducing health inequalities. 

Community pharmacies will offer much more than access to medicines, acting as local health and wellbeing hubs that support their communities to stay well and prevent ill health. This builds on existing initiatives, such as the development of Healthy Living Pharmacies. Community pharmacies will be an integral part of a wider integrated neighbourhood approach to population health and prevention. This might involve pharmacies themselves acting as local wellbeing hubs, or it might involve pharmacy teams supporting communities by reaching into other settings. 

Providing clinical care for patients 

Community pharmacies will have a much more clinically focused role, with members of the public consistently able to access care from community pharmacy teams for common conditions in a way that suits them and supports their health and wellbeing much more extensively than at present. This will expand on the emerging ‘Pharmacy First’ concept, with community pharmacists and their teams being seen by the public, and by other health care professionals, as a first port of call for many common ailments and some long-term conditions management. 

The clinical service offer can be expanded over time as pharmacists build their skills and qualifications (including as independent prescribers), as the wider health and care system becomes more accustomed to community pharmacies playing a larger role in clinical care, and as clinical governance systems and regulatory frameworks are updated to support this.

Living well with medicines 

Community pharmacy will support people to access and to live well with the medicines and treatments they are taking (including new and advanced therapies as they emerge) to improve outcomes, enhance safety and deliver better value. 

This will be a core role of pharmacies and it will evolve to make best use of the current and future skills and expertise of the community pharmacy team, working in collaboration with general practice, patients and carers. It will build on existing evidence and best practice guidance on medicines optimisation and cost-effective use of medicines. 

An integrated primary care offer for neighbourhoods 

Community pharmacy teams will be an integral part of a local integrated primary care offer, working closely with local general practice, allowing people access to care in their own neighbourhoods, supporting patients with ongoing care needs in addition to preventive and acute care.

Read the full report



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